Board of Supervisors - Hunter Mill District

Fairfax County, Virginia

CONTACT INFORMATION: Our office is open 8:30AM-5PM M-F

703-478-0283
TTY 711

1801 Cameron Glen Drive
Reston, VA 20190

Catherine M. Hudgins ,
Board of Supervisor

Community Room Reservation Form

TO USE THE NORTH COUNTY GOVERNMENTAL CENTER COMMUNITY ROOM FOR NONPROFIT PURPOSES.

Fields marked with asterisk * are required.

 

Name of Applicant or Representative *:

Email:

Phone *:

Address *:

City *:

State *:

Zip *:

Name of Organization Represented (if applicable):

IRS Tax ID Number (if applicable):

Title/Subject/Purpose of Activity *:

Number of Individuals Participating in this Activity *:

Category of Nonprofit Activity (check applicable):

Government

Private - County-Based Nonprofit Organization

Private - County Employee

Private - County Resident

Requested Date and Time of Activity:

First Choice *: Date: From: To:

Second Choice: Date: From: To:

No helium-filled balloons are allowed in the Community Room.

Will Advertisements/Brochures be distributed? Yes No
If Yes, fax a copy to the Hunter Mill District Office at 703-471-6847.

Will Food/Drinks be served? * Yes No
If Yes, describe:

Will a fee be charged to participants? * Yes No
If Yes, describe:


 

As with all correspondence received by the Board of Supervisors, the content of your message, including your name, address, phone numbers and E-Mail address, are subject to disclosure under the provisions of the Virginia Freedom of Information Act, and if requested must be provided.

 

For information about the use of the community room, see the Regulations for Public Use of Community Rooms at Fairfax County District Governmental Centers [PDF file].